Cats having GI problems, vets are not helping
December 8, 2012 6:16 AM   Subscribe

Cats suffering from blood in poop, diarrhea, vomiting for the past month. Vets keep telling me there's nothing wrong, all of their treatment suggestions haven't worked. Can't keep spending money on vets, please advise. Cat poop discussion inside!

I'm taking care of four cats (sorry, don't have pictures at the moment). Rosalind is an indoor/outdoor friendly stray. Daisy, Anatoli, and Aneta are indoor-only; Daisy is a recent ex-stray. Everyone is on Revolution, FIV- as of two months ago, and up to date on all vaccines. Litter box is scooped 1-2x daily, minimum, changed every 1-2 weeks.

A month ago Aneta had a lot of diarrhea with a lot of bright red blood in it in the middle of the night. She hadn't been eating as well and her stools had been loose prior. I completely freaked out and immediately took her to the vet. The vet did a stool analysis and found nothing wrong. $100 later, they gave me a couple cans of bland intestinal distress prescription cat food and sent me on my way.

Her stools slightly firmed up. Then Anatoli started to have the bloody diarrhea. This time I noticed tapeworms. All four cats got a dose of Drontal followed by another dose three weeks later.

Drontal worked for the first two weeks. The third week the bloody diarrhea from Aneta and Anatoli returned, accompanied by throwing up on an empty stomach almost daily. This did not improve after the second Drontal dose. So I took them to a second vet, who ALSO found nothing in their stool. This time I got metronidazole and a recommendation to give them canned pumpkin.

OK, fine. Well, a week of canned pumpkin and metronidazole later (again, treating all four cats) we are back to bloody diarrhea and barfing.

I am pretty sure this is a parasite, given two of the cats have it and one seems to have given it to the other. Daisy seems to be OK. Rosalind refuses to poop inside, so I don't know what's going on with her, though she hasn't thrown up. She's probably the disease vector though.

I'm wondering if it could be coccidia, as I read it's difficult to detect and some vets give medication on symptoms alone. Second vet straight-up refused to give medication for it since they saw nothing. What do I do next? Go to a third vet? I am running out of low-cost vets to go to.

Also--prior to this everyone was hale and hardy.
posted by schroedinger to Pets & Animals (13 answers total)
I'm fostering a kitten now who's 8 weeks old and has been firming up and loosening again for weeks. My rule of thumb is a 50/50 mix of canned pumpkin and greek yogurt (I like Fage 2%) -- as much as they can eat, for as long as it takes. Nothing else but water. Monday he was just spurting liquid constantly and I took him in -- the vet gave him B12 in an acupuncture spot in his anus (eek!) and we added Metronidizole -- his fecal showed nothing. He's been about 40% better -- everything has some shape, and it's all landing in the box. I want to note that Metronidizole has been hugely helpful for most of my fosters with this issue. I've only had one (well, now two) that seemingly refused to get better -- with him, the magic trick was Nutramax Proviable-DC, only available from a vet. With the other foster, I got it free because it was a sample hiding in the back of a drawer at the city shelter. This time, it happens that the vet at the clinic is familiar with the stuff and she's going to donate it to the kitten.

I don't know if such a thing exists in your city, but in Phila we have a rescue with a Wellness clinic -- basically check-ups, neuter/spay, routine stuff. If I were in your situation, I would call them and see if they or one of their vets has it, and would let you buy some.
posted by MeiraV at 7:18 AM on December 8, 2012 [2 favorites]

Anyway, they would probably sell it to you at or around cost. You may or may not have to have an office visit (under $40) & bring paperwork proving that all the first and second line stuff has been addressed, but since it's not really a 'drug' I don't think you'd have much trouble getting it, if you found someone who had it. Or call the company and request a sample, promising that you'll sing their praises to all the vets you've visited if it does the trick.

But in the meantime, the pumpkin and yogurt should keep things manageable.

Congrats! You've earned your PhD in cat poop!
posted by MeiraV at 7:28 AM on December 8, 2012

MeiraV--PAWS was the second vet I took them to. They've been on metronidizole and I'm getting more today. It got better for maybe a day or two and is back to the vomiting and hemotachezia. They've already been eating canned pumpkin. Won't the dairy in the yogurt make things worse?
posted by schroedinger at 7:31 AM on December 8, 2012

First off, you have a cat that goes indoors/outdoors in amongst all your other pets. That's a great way for you to expose them to all sorts of infections and parasites they wouldn't otherwise be exposed to. You can easily take years off of your cat's lifespan by doing this... cats that go indoors and outdoors lose about 4+ years off their life, on average.

Worse still, you are exposing your indoor cats to many of the same risks that your outdoor cats take... and oftentimes, indoor cats can be more vulnerable if suddenly exposed to new infections and parasites than ones who are exposed to them all the time.

If you are letting one of your cats go indoors and outdoors while you are trying to get rid of parasites, that's kind of the equivalent to trying to uninstall a persistent virus from your computer while you keep downloading pirated software from dodgy Russian websites. It's also a great way to needlessly throw away good money on vet visits and medicines, too.

Diagnosing *anything* is always easier when you simplify the situation, so that you can remove potential causes from the list, so by letting one of your cats outdoors, you are making the diagnosis process much harder than it needs to be, both for you, your vet, or anyone else on MeFi. We can all tell you what we think it *could* be, but in truth, it's somewhat of a shot in the dark, in part because you are making diagnosis harder than it needs to be. Your actions -- or inaction -- can kill your pets here.

If it's a parasite, it sounds a lot like hookworms or whipworms, which can be fatal if not treated / mistreated... but Drontal is supposed to kill them, and pretty much all the other worms too. But then again, you are supposed to not repeatedly expose your cats to hookworms or other parasites -- or any other thing it could be -- while trying to get rid of the problem.

Also note, it says this about whipworms:
"Signs may include any or all of the following: inapparent infestations, nonspecific diarrhea, blood-streaked diarrhea, unthriftiness, weight loss. Most infestations are inapparent. The problem is that whipworms can precipitate "recurring" diarrhea and colitis. Since the adult whipworms may not lay eggs everyday, if a fecal floatation is performed they might not be found. The diarrhea however, keeps coming and going. Like the hookworm, the whipworm also sucks blood, but not nearly as much. When the whipworm buries it's head in the intestinal wall it will cause a tremendous inflammatory reaction. The inflamed intestinal wall gets red, eroded and prone to invasion by bacteria. This is the underlying cause of the intermittent diarrhea. If the diarrhea is treated with antibiotics it will go away, only to come back later. The bacteria are killed, but if the whipworms are missed the damage to the intestinal wall continues allowing recurrent bacterial infection to invade the intestine and cause diarrhea."

So, in other words, depending upon the conditions of the treatment and the type of parasite, removal of the parasite could be hit or miss, as could detection of whether they are even there or not. That said, whipworms are much less common than other types of worms in cats.

Statistically, it's understandable that your vet said that the antibiotics killed the parasites... as far as they can tell. That doesn't mean that the antibiotics were all that good for your cat's digestive system, or that the worms didn't leave damage in their wake that may require time to heal, though.

Your litter box situation could be a very serious vector for infection, so you'll really want to stay on top of things. You have two considerably compromised cats here. You need to make sure they aren't at risk of getting infected / reinfected.

One thing I would also check is what kind of food they are eating. What do you feed them? What are the ingredients in it? Did you change what your cats were eating before the initial symptoms occurred? How do you feed them? Do you always feed them the same food in the same bowls? Are the food bowls kept clean? Is their water source kept *very* clean right now, away from things that could fall in it, and regularly emptied and refilled? If your recovering cats can use anything right now, it's good food and lots of clean, fresh water. It can really help.

Also note, it's quite possible for, say, two cats out of four to respond in the same negative way to food that they are either not used to or are allergic to... food allergies and intolerances in cats are pretty common.

You've got to really break down and identify the various risks to your cats -- especially the shared risks... the potential causes... and start taking serious steps to remove those risks.

But no. Nobody here can categorically tell you what your cat problem(s) are, and how to fix them. You really need to be sure you're doing everything you can, as well as you possibly can... especially now.
posted by markkraft at 8:03 AM on December 8, 2012 [2 favorites]

Do you have plants? SO MANY plants are toxic to cats.
posted by heatherann at 8:28 AM on December 8, 2012 [1 favorite]

My cats went to grain-free after one of them was puking constantly. They get Taste of the Wild crunchies now and it has largely gone away aside from occasional hairballs.
posted by gracedissolved at 8:43 AM on December 8, 2012 [1 favorite]

Ugh, I am so sorry.

First of all, I would try to segregate the one indoor/outdoor from the rest of them. markkraft is pretty forcefully making the point, and I can't help but agree. I know it's complex and will be difficult and a pain in the ass but she's bringing things in from the outside that your other cats just wouldn't be exposed to otherwise. It's a confounding factor that will stop you from solving this problem.

Once you segregate her away from the indoor-only cats, you're going to have to continue to treat. Once you get them normalized, . . .I don't know. there is obviously something pretty virulent that the indoor/outdoor cat is bringing in. It might be appropriate to try to rehome her to somewhere that she can't bring this kind of trouble to other kitties. :-(
posted by Medieval Maven at 8:47 AM on December 8, 2012

Making the indoor/outdoor cat indoor-only is not an option. Believe me, I would love to take her in permanently (and so would she) but I would be kicked out of my apartment. She's a feral who showed up with her babies in my backyard, I got the babies adopted, spayed her, and she tamed herself as I fed her. She's still skittish enough that she's not an easy adopt or foster though. Technically I'm not even supposed to have Daisy, but will hopefully find a foster home for her soon since she's a lot more people-friendly. Even re-homing the kittens was difficult, much less finding even temporary places for adult cats.

Their food is high-quality, high-protein, grain-free stuff, the same food it has always been. This issue did not start until a month ago. Water is fresh. They even have a filtered water fountain. No plants or anything.
posted by schroedinger at 8:47 AM on December 8, 2012

I am sorry to threadsit, but I want to emphasize that the situation of indoor/outdoor kitty is last resort, save leaving her outside permanently or taking her to Animal Control. I have been in contact with multiple rescue groups. City Kitties is full up on cats. Family and friends will not take her. Moving from my current apartment is also not an option. It is difficult enough to find a place to put the ultra-friendly Daisy, much less skittish Rosalind.

If anyone has had pets with similar symptoms I was just hoping to get other's experiences with these cat symptoms. Has your pet ever had a parasite that did not show up in stool samples?
posted by schroedinger at 9:42 AM on December 8, 2012

I recall a while back you mentioned feeding your cats Innova Evo dry...FWIW (and this is one of those single anecdotal data points that is not terribly useful) one of my cats suddenly developed bloody diarrhea while eating IE, even though he had been eating it uneventfully for years and none of the other cats were having problems. I switched him to another food and his problems went away.
posted by jamaro at 9:59 AM on December 8, 2012

I haven't had any problems giving yogurt -- the probiotics in the yogurt are HUGE help, and have made the difference in 75% of my foster kittens.

One thing I wonder about is are all fecals the same? A specialist with pricey contraptions might be able to find something that a low-cost clinic can't.

I'll memail you.
posted by MeiraV at 10:18 AM on December 8, 2012

I know next to nothing about cats, but your comment that they're eating canned pumpkin made me think of this comment, which states, "Cats are obligate carnivores and have not evolved to process grains. Many cat health problems ranging from fat, skinny, hairballs, urinary tract issues, and even diabetes can be traced to underconsumption of meat." Not sure about pumpkin, though. And I'm sure your vet knows what he/she is talking about.
posted by Dasein at 3:18 PM on December 8, 2012

Etiology of chronic vomiting and diarrhea in cats:

1. Parasites (helminths)
2. Viral disease (coronavirus, FeLV, FIV)
3. Bacteria (Salmonella, Campylobacter)
4. Protozoa (Giardia, Tritrichomonas)
5. Dietary (food intolerance, food allergy)
6. Neoplasia (lymphoma, adenocarcinoma)
7. Inflammatory diseases: Inflammatory Bowel Disease (IBD), cholangitis, chronic pancreatitis
8. Endocrinopathies (hyperthyroidism, diabetes mellitus, hypoadrenocorticism (rare))
9. Systemic diseases (kidney failure)
10. Motility disorders

From what you've written, many of the above causes can be ruled out.

Tritrichomonas is a newly emerging disease in cats. You could call up your vet to ask if it might have gone undetected in a fecal prep. Testing involves microscopic examination of a fresh fecal smear, PCR, or culture. It requires treatment with Ronidazole, or it eventually resolves. In like 9+ months.

More info.
posted by Seppaku at 6:50 PM on December 8, 2012 [2 favorites]

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